Rehydration after Diarrhea

Abstract

Babies with diarrhea undergo huge fluid loss; the main problems a physician faces are choosing the fluids for rehydration and deciding on the best way to administer them. Fluids should be rapidly absorbed from the intestinal lumen: this effect is maximized with a composition of salts and other components. The combined use of an oral rehydrating solution (ORS) and an appropriate regimen of refeeding is called oral rehydrating treatment (ORT). Fluid absorption can be promoted by the enteral administration of properly designed fluids, even in the presence of ongoing losses. Water passively follows the osmotic gradient generated by the transcellular transport of electrolytes and nutrients. This is why water alone cannot be usefully employed for oral rehydration. Nevertheless, with appropriate ORS, most dehydrated children can be rehydrated successfully without resorting to parenteral intravenous (or intraosseous, when necessary) therapy; here we will see when and how, and in which cases intravenous (iv) rehydration is suggested.